IntroductionGallstone ileus is a rare cause of bowel obstruction and results from the passage of gallstones into the bowel.Case presentationWe present the case of an 83-year-old Caucasian woman who had three episodes of gallstone ileus, each of which was managed with simple enterotomy. This sequence is one of the first reported in the medical literature and may be seen to challenge the traditional surgical approach of enterotomy alone.ConclusionsThe available evidence comparing enterotomy alone with combined enterotomy, cholecystectomy, and fistula closure in the management of gallstone ileus is reviewed. Neither approach is clearly identified as superior, but available series suggest that simple enterotomy may be safer than a combined approach and does not result in a higher rate of recurrent biliary disease.

The diagnosis of polymyositis in the elderly population should raise suspicion of an underlying malignancy.

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